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This item is sold only in sets of 100.This WHO booklet includes the Model International Certificate of Vaccination or Prophylaxis contained in Annex 6 of the "International Health Regulations" (2005). The Certificate is used for recording vaccinations or prophylaxis, in accordance with the IHR (2005), including vaccination or revaccination against yellow fever. Additional pages in the booklet have space for recording other vaccinations. (Please note that Certificates of vaccination are not sold individually.They are only available in packs of 100.)
The Codex standards for all fresh fruits and vegetables and relevant related texts including the Code of Hygienic Practice for Fresh Fruits and Vegetables. This first edition includes all texts adopted by the Codex Alimentarius Commission up to 2007. Also published in French and in Spanish.
Codex guidelines and codes of practice concerning animal food production are published in this compact format to allow their wide use and understanding by governments, regulatory authorities, food industries and retailers, and consumers. This second edition includes the texts adopted by the Codex Alimentarius Commission up to 2009. Published also in French and Spanish.
The second edition of this pocket book is for use by doctors, senior nurses and other senior health workers who are responsible for the care of young children at the first referral level in developing countries. It presents up-to-date clinical guidelines which are based on a review of the available published evidence by subject experts, for both inpatient and outpatient care in small hospitals where basic laboratory facilities and essential drugs and inexpensive medicines are available. In some settings, these guidelines can be used in the larger health centers where a small number of sick children can be admitted for inpatient care.The guidelines are for use in both inpatient and outpatient care in hospitals with basic laboratory facilities and essential medicines. These guidelines focus on the management of the major causes of childhood mortality in most developing countries, such as newborn problems, pneumonia, diarrhoea, malaria, meningitis, septicaemia, measles and related conditions, severe acute malnutrition and paediatric HIV/AIDS. It also covers common procedures, patient monitoring and supportive care on the wards and some common surgical conditions that can be managed in small hospitals.
In this report, the World Health Organization's Special Program for Tropical Diseases Research (TDR), in collaboration with the Foundation for Innovative New Diagnostics (FIND), has compiled existing epidemiological data and generated a wealth of new data on the availability of TB laboratory services, variations in physician diagnostic practices, workloads of national laboratory networks, and manufacturer's sales to authoritatively document the volume and market value of TB diagnostic testing in nearly 200 countries. Customer requirements and R& D opportunities are clarified and the major scientific, financial, and market entry challenges specific to TB diagnostic development are presented alongside short and long term strategies and solutions. Furthermore, the potential future TB diagnostic market is estimated for a range of hypothetical new diagnostic tests covering the three major testing indications. Fourteen countries are profiled in detail to complement the global perspective. This report drafted with extensive input from experts in tuberculosis and public health, as well as from private industry, provides essential data and knowledge to dispel common myths and inform investment decisions by industry foundations, government organizations, and world health and financial organizations. The report is comprised of seven chapters, fourteen country profiles, and an appendix addressing global in vitro diagnostic regulatory practices and classification schemes.
"WHO Classification of Soft Tissue and Bone" is the fifth volume of the 4th Edition of the WHO series on histological and genetic typing of human tumors. This authoritative, concise reference book provides an international standard for oncologists and pathologists and will serve as an indispensable guide for use in the design of studies monitoring response to therapy and clinical outcome. Diagnostic criteria, pathological features, and associated genetic alterations are described in a strictly disease-oriented manner. Sections on all recognized neoplasms and their variants include new ICD-O codes, epidemiology, clinical features, macroscopy, pathology, genetics, and prognosis and predictive factors.This book is in the series commonly referred to as the "Blue Book" series.
The second edition of this popular textbook provides an introduction to the principles and methods of epidemiology. Since publication of the first edition in 1993, Basic epidemiology has become a standard reference for education, training and research in the field of public health and has been translated into more than 25 languages. It is used widely, for training public health and environment professionals, undergraduate medical students, and students in other health professions. The second edition provides updated examples of how and why the basics of epidemiology are essential to anyone who is required to understand and apply the principles of disease causation and prevention. The book has a particular emphasis on modifiable environmental factors and encourages the application of epidemiology to the prevention of disease and the promotion of health, including environmental and occupational health. It prepares members of the health-related professions to respond to the need for health services to address all aspects of the health of populations, and to ensure that health resources are used to the best possible effect. It shows how good clinical practice is informed by clinical epidemiology; and its lively, concise style is designed to stimulate a continuing interest in the subject. This edition includes comprehensive chapters on the nature and uses of epidemiology; the epidemiological approach to defining and measuring the occurrence of health-related states in populations; the strengths and limitations of epidemiological study designs, causation, the contribution of epidemiology to the prevention of disease, the promotion of health and the development of health policy, and the role of epidemiology in evaluating the effectiveness and efficiency of health care. It enables students to describe the common causes of death, disease and disability in her or his community; outline appropriate study designs to answer specific questions concerning disease causation, natural history, prognosis, prevention, and the evaluation of therapy and other interventions to control disease, and critically evaluate the literature.
A consolidated edition providing the Codex standards and relevant related texts, including the Code of practice for the prevention of mycotoxin contamination in cereals. This first edition contains texs adopted by the Codex Alimentarius Commission up to 2007. Also published in French and Spanish.
Provides clinical descriptions, diagnostic guidelines, and codes for all mental and behavioural disorders commonly encountered in clinical psychiatry. The book was developed from chapter V of the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The clinical descriptions and diagnostic guidelines were finalized after field testing by over 700 clinicians and researchers in 110 institutes in 40 countries, making this book the product of the largest ever research effort designed to improve psychiatric diagnosis. Every effort has been made to define categories whose existence is scientifically justifiable as well as clinically useful. The classification divides disorders into ten groups according to major common themes or descriptive likeness, a new feature which makes for increased convenience of use. For each disorder, the book provides a full description of the main clinical features and all other important but less specific associated features. Diagnostic guidelines indicate the number, balance, and duration of symptoms usually required before a confident diagnosis can be made.Inclusion and exclusion criteria are also provided, together with conditions to be considered in differential diagnosis. The guidelines are worded so that a degree of flexibility is retained for diagnostic decisions in clinical work, particularly in the situation where provisional diagnosis may have to be made before the clinical picture is entirely clear or information is complete. "...As befitting a publication of considerable influence, the amount of work that went into preparing ICD-10 has been formidable..." - The International Journal of Social Psychiatry
The WHO Guidelines on Hand Hygiene in Health Care provide health-care workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specific recommendations to improve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present Guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population. Therefore, this concept applies to all settings where health care is permanently or occasionally performed, such as home care by birth attendants. Definitions of health-care settings are proposed in Appendix 1. These Guidelines and the associated WHO Multimodal Hand Hygiene Improvement Strategy and an Implementation Toolkit (http: //www.who.int/gpsc/en/) are designed to offer health-care facilities in Member States a conceptual framework and practical tools for the application of recommendations in practice at the bedside. While ensuring consistency with the Guidelines recommendations, individual adaptation according to local regulations, settings, needs, and resources is desirable.This extensive review includes in one document sufficient technical information to support training materials and help plan implementation strategies. The document comprises six parts.
Food labelling is the primary means of communication between the producer and seller of food on one hand, and the purchaser and consume on the other. The Codex Alimentarius standards and guidelines on food labelling are now collected in this compact format to allow their wide use and understanding by governments, regulatory authorities, food industries and retailers, and consumers. This fifth edition includes all texts adopted by the Codex Alimentarius Commission up to 2007. Also published also in French and Spanish.
Diagnosis within psychiatry involves the consideration of a number of different features of mental state. In making a diagnosis, individual psychiatrists inevitably accord differing importance to certain features. By regulating the order and number of conditions to be recorded, a multiaxial framework provides for internationally comparable descriptions of mental state. This volume provides the psychiatric sections of ICD10 in a form that is adapted for ease of use of those dealing with mental disorders in childhood and adolescence. Descriptions have been grouped into axes which have been chosen to provide unambiguous information of maximum clinical usefulness in the greatest number of cases. Building on the popular original framework of four axes, the system has been greatly improved by the inclusion of a new axis for psychosocial situations and by the addition of a further sixth axis on adaptive level which enables clinicians to code an individual's current level of disability.
This annual edition presents the most recent statistics of over 50 health indicators for WHO's 193 Member States. It includes an expanded set of core statistics and a section with 10 highlights in global health statistics for the past year. This book has been collated from publications and databases of WHO's technical programmes and regional offices. The core set of indicators was selected on the basis of relevance for global health, availability and quality of data, and accuracy and comparability of estimates. The statistics for the indicators are based on an interactive process of data collection, compilation, quality assessment, and estimation between WHO technical programmes and its Member States. In this process, WHO strives to maximize accessibility, accuracy, comparability, and transparency of country health statistics. In addition to national statistics, this publication presents statistics on the distribution of selected health outcomes and interventions within countries, disaggregated by gender, age, urban/rural setting, wealth/assets, and educational level. Such statistics are primarily derived from the analysis of household surveys and are only available for a limited number of countries.
Given the impact that good nutrition and keeping fit have on health and well-being in later life, WHO, in collaboration with the Tufts University USDA Human Nutrition Research Center on Aging, organized a consultation to review the scientific evidence linking diet and other factors - especially exercise - affecting nutritional status, disease prevention and health promotion for older persons. The consultation focused primarily on practical issues, including the establishment of explicit recommendations to improve the health and nutritional status of older persons in a wide variety of socioeconomic and cultural settings. During the production of a comprehensive report, representing the outcome both of the preparatory work and of the consultation itself, it was recognized that new information emerging in several key areas should also be included. The combined results presented here are intended as an authoritative source of information for nutritionists, general practitioners, gerontologists, medical faculties, nurses, care providers, schools of public health and social workers.The specific recommendations concerning nutrient intakes, food-based dietary guidelines, and exercise and physical activity should also interest a larger audience, including the general reader. The main body discusses the epidemiological and social aspects of ageing, health and functional changes experienced with ageing, the impact of physical activity, assessment of the nutritional status of older persons, and nutritional guidelines for healthy ageing. Additional material covers food-based dietary guidelines for older adults - with particular emphasis on healthy ageing and prevention of chronic noncommunicable diseases - and guidelines for promoting physical activity among older persons. "...This report is significant, representing an authoritative consensus related to the epidemiological and social aspects of ageing, health and functional changes experienced with age, and the impact of physical activity. This valuable source of information is relevant to a wide range of health professionals; the clear and specific recommendations concerning food/nutrient consumption and physical activity for older adults should also interest a larger audience."- The Journal of the Royal Society for the Promotion of Health "...The book is a timely publication, which provides an exhaustive review of studies...This publication will certainly serve as a reference manual for all those involved in nutrition, gerontology and geriatrics. " - Indian Journal of Medical Research
The longstanding debate over the optimal duration of exclusive breastfeeding has centered on the so-called "weanling's dilemma" in developing countries: the choice between the known protective effect of exclusive breastfeeding against infectious morbidity and the (theoretical) insufficiency of breast milk alone to satisfy the infant's energy and micronutrient requirements beyond 4 months of age. The primary objective of this review is to assess the effects on child health, growth, and development, and on maternal health, of exclusive breastfeeding for 6 months vs exclusive breastfeeding for 3-4 months with mixed breastfeeding (introduction of complementary liquid or solid foods with continued breastfeeding) thereafter through 6 months.
This report issues a call for urgent action to combat the growing epidemic of obesity, which now affects developing and industrialized countries alike. Adopting a public health approach, the report responds to both the enormity of health problems associated with obesity and the notorious difficulty of treating this complex, multifactorial disease. With these problems in mind, the report aims to help policy-makers introduce strategies for prevention and management that have the greatest chance of success. The importance of prevention as the most sensible strategy in developing countries, where obesity coexists with undernutrition, is repeatedly emphasized.Recommended lines of action, which reflect the consensus reached by 25 leading authorities, are based on a critical review of current scientific knowledge about the causes of obesity in both individuals and populations. While all causes are considered, major attention is given to behavioural and societal changes that have increased the energy density of diets, overwhelmed sophisticated regulatory systems that control appetite and maintain energy balance, and reduced physical activity. Specific topics discussed range from the importance of fat content in the food supply as a cause of population-wide obesity, through misconceptions about obesity held by both the medical profession and the public, to strategies for dealing with the alarming prevalence of obesity in children.The report has eleven chapters presented in five parts. Part one, which assesses the magnitude of the problem, explains the system for classifying overweight and obesity based on the body mass index, considers the importance of fat distribution, and provides an overview of trends in all regions of the world, concluding that obesity is increasing worldwide at an alarming rate. Chapters in part two evaluate the true costs of obesity in terms of physical and mental ill health, and the human and financial resources diverted to deal with these problems. Specific health consequences discussed include increased risk of cardiovascular disease, cancer, and other noncommunicable diseases, endocrine and metabolic disturbances, debilitating health problems, and psychological problems. The health benefits and risks of weight loss are also assessed.Part three draws on the latest research findings to consider specific factors involved in the development of overweight and obesity. Discussion centres on factors, such as high intakes of fat, that may disrupt normal physiological regulation of appetite and energy balance, and the role of dietary factors and levels of physical activity. In terms of opportunities for prevention, particular attention is given to the multitude of environmental and societal forces that adversely affect food intake and physical activity and may thus overwhelm the physiological regulatory systems that keep weight stable in the long term. The possible role of genetic and biological susceptibility is also briefly considered.Against this background, the fourth and most extensive part maps out strategies for prevention and management at both the population and individual levels. Separate chapters address the need to develop population-based strategies that tackle the environmental and societal factors implicated in the development of obesity, and compare the effectiveness of current options for managing overweight or obese individuals. Specific strategies discussed include dietary management, physical activity and exercise programmes, behaviour modification, drug treatment, and gastric surgery. While noting striking recent progress in the development of drug treatments, the report concludes that gastric surgery continues to show the best long-term success in treating the severely obese. The final part sets out key conclusions and recommendations for responding to the global obesity epidemic and identifies priority areas where more research is urgently needed...". the volume is clearly written, and carries a wealth of summary information that is likely to be invaluable for anyone interested in the public health aspects of obesity and fatness, be they students, practitioner or researcher." - Journal of Biosocial Science
A practical guide to the principles and methods of cost analysis as a managerial tool for improving the efficiency of hospitals. Addressed to managers and administrators, the manual aims to equip its readers with the knowledge and skills needed to calculate the costs of different activities or departments, analyze their significance, and use this information to manage resources wisely. Throughout, recommendations and advice are specific to the different purposes of cost analysis and the different types of decisions commonly facing managers. The manual, which is intended for use as a training tool, was finalized following extensive field- testing in workshops in Bangladesh, Egypt, and Zimbabwe. Methods of cost-finding and cost analysis are thoroughly explained and illustrated with practical examples and model step-by-step procedures for performing calculations. Since hospital accounting systems in developing countries may have gaps or inaccuracies, the manual gives particular attention to reliable methods for estimating costs when existing data are problematic. The manual opens with an explanation of the many advantages of using cost-finding and cost analysis as managerial tools. These include the provision of data needed for informed decisions on operations and infrastructure, investment, the planning of future budgets, the establishment of charges for patient services, and the development of mechanisms for ensuring that costs do not exceed available revenues and subsidies. Against this background, the core of the manual is presented in three chapters. The first, and most extensive, chapter explains how to allocate costs to cost centers and how to compute unit costs. Information and examples are presented according to seven steps. Each is discussed in terms of the types of data needed, how component cost items should be treated, and how costs can be computed in particular situations or cases. Practical examples are used to illustrate the types of questions addressed in cost analysis and the value of this information in guiding decisions. Chapter two explains how cost data can be used to improve the management of an individual hospital. Information is intended to guide decisions at both the cost center, or department, level and the hospital level. Managerial tasks covered include: budgeting; profitability; efficiency improvements; contracting outside services or producing in-house; and assessing fiscal solvency. Chapter three considers the use of cost data in managing national and regional hospital systems. Specific applications include improvements in the referral system, the appropriate use of different providers of services, and the comparison of similar hospitals to identify inefficiencies or sources of waste. The manual concludes with a series of practical exercises, followed by explanations of their answers.
Reports the recommendations and conclusions of an expert committee convened to assess progress in implementation of the Global Malaria Control Strategy, adopted in 1992. Issued at a time when malaria control is one of the highest priorities at WHO, the report offers expert advice on the full range of questions - from the best measures for ensuring early diagnosis and prompt treatment to strategies for the prevention of drug resistance - that can help countries strengthen programmes for control. The report opens with fact, figures, and maps profiling the current global malaria situation, including trends in the spread and intensification of parasite resistance to antimalarial drugs. Section two considers the extent to which each of four technical elements of the global strategy has been implemented over the past decade. The relationship of malaria control programmes to health sector reforms is explored in the next section, which focuses on the impact of health system decentralization, reforms in health-care financing, and the growth of partnerships with communities and the private sector. Against this background, the components of proper disease management are presented and discussed in terms of their relevance to control programmes. Topics covered include the advantages and disadvantages of diagnosis based on clinical observations, the role of microscopical and other tests for parasite detection, and the factors to consider when deciding on treatment objectives and recommended drugs. The difficult question of drug supply in the absence of formal health services is also considered. Subsequent sections offer advice on techniques for monitoring drug resistance and therapeutic efficacy, strategies for the containment of parasite drug resistance, and methods for the prediction and control of malaria epidemics. A section on the prevention of malaria describes various approaches to vector control, including the use of insecticide-treated bednets and other materials, the management of malaria in development projects, and the current status of drugs used for chemoprophylaxis. The remaining sections discuss information systems and operational research, and describe WHO's new Roll Back Malaria initiative.
This book evaluates the risks to human and animal health posed by the consumption of maize and maize-based products contaminated with fumonisin B1. This naturally occurring mycotoxin, produced by the mold "Fusarium verticillioides" is found in high concentrations throughout the world, and is believed to be the most prevalent and toxic of the fumonisins. Consumption is known to cause two fatal diseases in farm animals. Possible adverse effects on human health are of particular importance in several developing countries, where maize and maize-based products are the staple food for large populations. A section on sources of human exposure considers factors that influence the vulnerability of maize to contamination during growth, storage, and processing. Weather conditions that favor Fusarium kernel rot are noted to cause significant accumulation of fumonisin B1. Studies of the effects of different processing techniques demonstrate the toxin's stability. Dry milling results in its distribution into the bran, germ, and flour. In experimental wet milling, fumonisin has been detected in steep water, gluten fibre, and germ but not in the starch. A review of studies on the environmental fate of fumonisin B1 concludes that fumonisins are heat stable, light stable, water soluble, poorly absorbed, poorly metabolized, and rapidly excreted by animals. As a result, most fumonisin is recycled into the environment in a manner that concentrates its spatial distribution. A section on environmental levels and human exposure reviews a large number of studies measuring levels of contamination in maize and maize-based foods for human consumption and in animal feeds. The highest levels of contamination have been recorded in Europe, followed by North America, Africa, Asia, and Latin America. The most extensive section reviews toxicity data from studies in experimental animals and "in vitro "test systems. Fumonisin B1 has been shown to be hepatotoxic in all animal species tested, and nephrotoxic in several species. The report found no evidence that consumption of fumonisins causes adverse effects on development or reproductive functions in farm animals or humans. Studies in some species indicate an association between exposure and the development of renal and liver cancers. The evaluation also drew on extensive investigations of equine leukoencephalomalacia and porcine pulmonary oedema syndrome, fatal diseases which have been causally linked to the consumption of fumonisin-contaminated feeds. These and other lines of evidence suggest that fumonisin B1 exerts its toxic action by inhibiting cell growth and causing accumulation of free sphingoid bases and alteration of lipid metabolism. The evaluation of effects on human health draws on limited evidence from correlation studies in South Africa and China, and an analytical study from northern Italy, suggesting a link between direct fumonisin exposure and esophageal cancer. Due to weaknesses in all these studies, no firm conclusions could be reached. No confirmed records of acute fumonisin toxicity in humans were available for evaluation. A final section draws attention to the urgent need for more knowledge about the effects of food processing and cooking, especially in developing countries, on levels of contamination for epidemiological studies of adverse health effects, and for better understanding of the mode of toxic action in humans.
The World Health Report 2000 is an expert analysis of the increasingly important influence of health systems in the daily lives of people worldwide. To an unprecedented degree it takes account of the role of people as providers and consumers of health services, as financial contributors to health systems, as workers within them, and as citizens engaged in their responsible management, or stewardship. Health systems provide the critical interface between life-saving, life-enhancing interventions and the people who need them. If health systems are weak, the power of these interventions is likewise weakened, or even lost. Health systems thus deserve the highest priority in any efforts to improve health or ensure that resources are wisely used. In recent decades, health systems have contributed enormously to better health for most of the global population. As the new century begins, they have the potential to achieve further improvements in human wellbeing, especially for the poor. But very little has yet been done to unravel the complex factors which explain good or bad performance by individual health systems. Given equal resources, why do some succeed where others fail? Is performance simply driven by the laws of supply and demand, or does another logic apply? Why is dissatisfaction with services so widespread, even in wealthy countries offering the latest interventions? If systems need improvement, what tools exist to measure performance and outcomes? These are some of the many questions addressed in this report. Drawing upon a range of experiences and analytical tools, the report traces the evolution of health systems, explores their diverse characteristics, and uncovers a unifying framework of shared goals and functions. Using this as a basis for analysis, the report breaks new ground in presenting an index of health system performance based on three fundamental goals: improving the level and distribution of health, enhancing the responsiveness of the system to the legitimate expectations of the population, and assuring fair financial contributions. As the report convincingly argues, good performance depends critically on the delivery of high-quality services. But it relies on more than that. Health systems must also protect citizens from the financial risks of illness and meet their expectations with dignified care. The report goes on to show how the achievement of these goals depends on the ability of each system to carry out four main functions: service provision, resource generation, financing, and stewardship. Chapters devoted to each function offer new conceptual insights and practical advice on how to assess performance and achieve improvements with available resources. In doing so, The World Health Report 2000 aims to stimulate a vigorous debate about better ways of measuring health system performance and thus finding a successful new direction for health systems to follow. By shedding new light on what makes health systems behave in certain ways, WHO also hopes to help policy-makers understand the many complex issues involved, weigh their options, and make wise choices.
This book provides a collection of ten protocols for conducting rapid health assessments in the immediate aftermath of different types of emergencies. Noting the vital importance of rapid and accurate information in the earliest stage of an emergency, the protocols respond to the urgent need for common standardized technical tools for assessing damage, gauging health risks, and gathering the information immediately needed by decision-makers at the national and international level. The protocols were prepared by WHO in collaboration with a large number of international agencies and experts with broad experience in the field of emergency management. Although all protocols follow a common format, each is specific to the circumstances, potential hazards, and immediate information needs that characterize a distinct type of emergency. Emphasis is placed on the exact information needed, the best sources of data and methods for rapid collection, and the specific questions that need to be answered in order to draw initial conclusions and direct immediate actions.Although the advantages of using experienced assessments teams are stressed, the book also explains how the protocols can be used to train general health workers as part of emergency preparedness. The book opens with an introductory protocol covering the aims and methods, responsibilities, complexities, and inherent difficulties of rapid health assessments. Addressed to health authorities as well as assessment teams, the chapter also includes abundant advice on preparedness for emergencies. Details range from the comparative need for speed in different types of emergencies, through a suggested format for presenting the results of assessments, to a list of common logistic, organizational, and technical errors. Advice on the best working practices, including ways to avoid being an "emergency tourist", is also provided. Against this background, the additional nine protocols are presented according to a common format which covers the purpose of the assessment, preparedness, the steps to follow during the assessment, assessing the impact on health, assessing local response capacity and immediate needs, and presenting results.A general protocol on epidemics of infectious origin is followed by protocols specific to meningitis outbreaks, outbreaks of viral haemorrhagic fever, including yellow fever, and outbreaks of acute diarrhoeal disease, with information specific to dysentery and cholera. Sudden-impact natural disasters are covered in the next protocol, which includes a day-by-day list of information priorities for different stages of the disaster. A protocol dealing with sudden population displacements offers guidelines for conducting rapid health assessments in all emergencies caused by sudden displacement of refugees or population groups within a country. Included are a sample checklist for rapid assessments and a sample form for weekly reports on morbidity and mortality. Subsequent protocols deal with the special situations of nutritional emergencies and chemical emergencies, including those caused by food contaminated with chemicals or toxins. The final protocol addresses the difficult task of conducting assessments in complex emergencies in which the cause of the emergency, as well as the assistance to the afflicted, is complicated by intense levels of political considerations.The protocol includes a form which has recently been used for rapid health assessment at local level in Bosnia and Herzegovnia. The book concludes with a brief summary of survey techniques, followed by a tabular presentation of reference values for assessing needs, hazards, and logistic requirements in developing countries.
A state-of-the-art review of methods and procedures for assessing the risks to human health posed by environmental chemicals. Addressed to regulatory authorities, risk managers and other decision-makers, the book aims to demystify the principles of risk assessment and thus encourage wider use of this powerful tool for protecting populations. Since the detection of chemical hazards may have socioeconomic and political consequences, the book gives particular attention to methods for the accurate identification of risks and determination of their severity. The book has four chapters covering each logical step in the process of risk assessment. The first, on hazard identification, explains how data on a chemical's toxicity and mode of action can be used to determine whether the chemical will cause adverse effects on health. The strengths and limitations of different types of data are discussed together with criteria commonly used to establish causality. Methods for assessing dose-response relationships are reviewed in chapter two, which explains how to characterize the relationship between the dose administered or received and the incidence of an adverse effect. Exposure assessment is covered in the next chapter, which describes methods for determining the nature and extent of contact with chemical substances and discusses the characteristics of exposure in the general environment, in the workplace, and from consumer products. The final chapter explains the procedure of risk characterization as a decision-making tool that brings together estimates of exposure levels and risks and summarizes sources of uncertainty in the scientific data. Practical options for risk management are presented asa range of regulatory, non-regulatory, economic, and technological measures.
A collection of 28 monographs covering the quality control and traditional and clinical uses of selected medicinal plants. Plants were selected for inclusion on the basis of their widespread use, particularly in countries that rely heavily on medicinal plants to meet primary health care needs. Monographs are provided for a number of phytomedicines traditionally used to treat such common complaints as diarrhoea, constipation, headache, appetite loss, sleep disorders, fatigue, and mild respiratory, gastrointestinal, and skin disorders. Additional medical applications assessed range from the lipid-lowering potential of garlic powder preparations, through the possible antiplasmodial activity of Fructus Bruceae, to the role of curcumin in promoting peptic ulcer healing and reducing the associated abdominal pain. In preparing and publishing these monographs, WHO aims to encourage standardized scientific approaches to ensuring the safety, quality and efficacy of medicinal plants and their products. The monographs are also intended to promote international harmonization in the quality control and use of herbal medicines and to serve as models for the development of national formularies. Draft monographs were finalized following review by over 100 experts in 40 countries. Some 1400 references to the literature are included. Each monograph follows a standard format, with information presented in two parts. The first gives pharmacopoeial summaries for quality assurance, botanical features, distribution, identity tests, purity requirements, chemical assays, and active or major chemical constituents. A section on definition provides the Latin binomial pharmacopoeial name, the most important criterion in quality assurance. Latin pharmacopoeial synonyms and vernacular names, listed in the section on synonyms and selected vernacular names, are those names used in commerce or by local consumers. The second part of each monograph begins with a list of dosage forms and of medicinal uses categorized as uses supported by clinical data, uses described in pharmacopoeias and in traditional systems of medicine, and uses described in folk medicine, but not yet supported by experimental or clinical data. Each monograph also includes an extensive review of available data on experimental and clinical pharmacology, followed by information on contraindications, such as sensitivity or allergy, warnings, precautions, particularly in such special groups as pregnant and breast-feeding women, adverse reactions, and dosage. A list of references concludes the monograph. Plants covered in volume 1 Bulbus Allii Cepae Bulbus Allii Sativi Aloe Aloe Vera Gel Radix Astragali Fructus Bruceae Radix Bupleuri Herba Centellae Flos Chamomillae Cortex Cinnamomi Rhizoma Coptidis Rhizoma Curcumae Longae Radix Echinaceae Herba Echinaceae Purpureae Herba Ephedrae Folium Ginkgo Radix Ginseng Radix Glycyrrhizae Radix Paeoniae Semen Plantaginis Radix Platycodi Radix Rauwolfiae Rhizoma Rhei Folium Sennae Fructus Sennae Herba Thymi Radix Valerianae Rhizoma Zingiberis
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